optimal training frequency for oral stimulation and non-nutritive sucking in preterm infants: a randomized clinical trial

Background: oral stimulation program and non-nutritive sucking (nns) have been introduced as a training program to promote oral feeding skills in preterm infants. however, no studies are available on the effects of different frequencies of performing this program on infants' feeding skills. the current study sought to find the more effective training frequency for this program on oral feeding skills of preterm infants.methods: thirty-two preterm infants were randomly allocated to two groups. infants in groups i and ii respectively received one and two sessions of the oral stimulation program and nns training per day for ten days. the outcome measures included transition time, dependency on tube feeding upon discharge, preterm oral feeding readiness scale (pofras) score improvement, and weight gain during two weeks.results: no significant differences were observed in the transition time and infant weight gain during two weeks. both groups significantly improved the mean of pofras scores during the intervention period (22.63 ± 4.08 to 27.69 ± 3.14 in group i; and from 20.13 ± 5.89 to 28.88 ± 3.00 in group ii; p < 0.001 for both groups). the pofras score was significantly more improved in group ii (p = 0.045). the ratio of infants who had reached full oral feeding upon discharge to those who were still tube-fed was almost 1.3 to 1 in group i versus 7 to 1 in group ii.conclusion: when the oral stimulation program and non-nutritive sucking are implemented twice a day, compared to only once, the probability of discharge of infants without a feeding tube may increase, and the level of their oral feeding readiness improves more, without having a detrimental effect on the weight gain of infants.